Interdisiplinary and intraobserver reliability of the Greulich-Pyle method among Turkish children
Author:
Sariyilmaz Kerim1ORCID, Abali Saygin2, Ziroglu Nezih3, Cingoz Tunca3, Ozkunt Okan4, Abali Zehra Yavaş5, Kalayci Cem Burak6, Hayretci Merve6, Semiz Serap2
Affiliation:
1. Department of Orthopedics and Traumatology , Acibadem Mehmet Ali Aydinlar University School of Medicine , Istanbul , Türkiye 2. Department of Pediatric Health and Diseases, Pediatric Endocrinology , Acibadem Mehmet Ali Aydinlar University School of Medicine , Istanbul , Türkiye 3. Department of Orthopedics and Traumatology, Acibadem Atakent Hospital , Acibadem Mehmet Ali Aydinlar University , Istanbul , Türkiye 4. Department of Physical Medicine and Rehabilitation, Medicine Faculty , Biruni University , Istanbul , Türkiye 5. Department of Pediatric Health and Diseases, Pediatric Endocrinology, Pendik Training and Research Hospital , Marmara University , Istanbul , Türkiye 6. Department of Radiology, Acibadem Atakent Hospital , Acibadem Mehmet Ali Aydinlar University , Istanbul , Türkiye
Abstract
Abstract
Objectives
Greulich-Pyle (GP) is one of the most used method for bone age determination (BAD) in various orthopedic, pediatric, radiological, and forensic situations. We aimed to investigate the inter- and intra-observer reliability of the GP method between the most relevant disciplines and its applicability to the Turkish population.
Methods
One-hundred and eighty (90 boys, 90 girls) patients with a chronological age younger than 18 (mean 9.33) were included. X-rays mixed by the blinded investigator were evaluated by two orthopedists, two radiologists, and two pediatric endocrinologists to determine skeletal age according to the GP atlas. A month later the process was repeated. As a statistical method, Paired t-test was used for comparison, an Intraclass Correlation Coefficients test was used for reliability and a 95 % confidence interval was determined. Results were classified according to Landis-Koch.
Results
All results were consistent with chronological age (p<0.001), according to the investigators’ evaluations compared with chronological age. At the initial evaluation, the interobserver reliability of the method was 0.999 (excellent); at the second evaluation, the interobserver reliability was 0.997 (excellent). The intra-observer reliability of the method was ‘excellent’ in all observers. When results were separately evaluated by gender, excellent intraobserver correlation and excellent correlation with chronological age were found among all researchers (>0.9). When X-rays were divided into three groups based on age ranges and evaluated, ‘moderate’ and ‘good’ correlations with chronological age were obtained during the peripubertal period.
Conclusions
The GP method used in skeletal age determination has excellent inter- and intra-observer reliability. During the peripubertal period, potential discrepancies in bone age assessments should be kept in mind. This method can be used safely and reproducibly by the relevant specialists.
Publisher
Walter de Gruyter GmbH
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism,Pediatrics, Perinatology and Child Health
Reference28 articles.
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